No Surprises Act Has Little Impact on In-Network Imaging Claims
GAO reports the No Surprises Act had minimal impact on radiology, with inânetwork claims steady at ~99% and slight declines in payment rates.
Read moreThe Centers for Medicare and Medicaid Services (CMS) this year added code 76937 to chapter 9 (Section H, General Policy Statements) of the 2024 National Correct Coding Initiative (NCCI) Policy Manual:
Radiological supervision and interpretation codes include all radiological services necessary to complete the service. Current Procedural Terminology® (CPT®) codes for fluoroscopy/fluoroscopic guidance (e.g., 76000, 77002, 77003) or ultrasound/ultrasound guidance (e.g., 76942, 76998, 76937) shall not be reported separately.
However, the agency evaluated comments and information provided by multiple specialty societies and reversed its decision and CMS removed code 76937. The removal will be reflected in the 2025 policy manual as CMS updates the NCCI Policy Manual once per year
There were no new or proposed NCCI procedure-to-procedure edits for code 76937. Radiology practices should continue to report code 76937 when it is performed and appropriately documented with other procedures (embolization, selected catheter placement, dialysis circuit access, etc.). Refer to the 2024 CPT code book for additional coding guidance.
For more information, contact Maria Tran, American College of Radiology® Director, Economic Policy.
No Surprises Act Has Little Impact on In-Network Imaging Claims
GAO reports the No Surprises Act had minimal impact on radiology, with inânetwork claims steady at ~99% and slight declines in payment rates.
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